PAUL E. COX MD, MSOCULUS SKINCARE, LASER AND

LONGEVITY

What you must know about hormone optimization for Men

Paul E. Cox MD, MS

Master’s in Exercise Physiology, UT Knoxville, 1995 University of Tennessee Medical School, Memphis,

1999 Board Certified in Family Medicine 2002, 2009 Fellowship trained in Anti-Aging Medicine 2008 Board Certified in Anti-Aging Medicine 2009 Oculus Skincare, Laser and Longevity center 2012

What is Regenerative or Integrative Medicine?

The field of scientific research aimed at the early detection, prevention, treatment and reversal of age related decline.

We accomplish this by the optimization of the body’s mechanisms of self repair with hormones, lifestyle and neutraceuticals (vitamins and herbal supplements).

Integrative medicine

We focus on the unique biochemistry of each person to tailor unique interventions to restore balance.

Current medical model is broken

Short office visits with long wait times

Impersonal service with a prescription to cover up symptoms but not address the real problem

Why Regenerative Medicine

No education provided to patients to explain the difference between disease and optimal health

Stressed and overworked doctors are unaware of the latest medical evidence

The current medical model is dedicated to preserving compromised health rather than improving health

Functional Medicine

Functional medicine is the integrative ,science based approach to healthcare that treats illness and promotes wellness by focusing on the unique biochemistry of each person to tailor unique interventions to restore balance.

Steroid Hormone Pathway

Why do hormone systems fail?

StressDecline with ageChronic disease (Diabetes)Medications ( pain, cholesterol, blood

pressure )Genetic factors Environmental factors (pesticides, plastics,

pollution)Poor nutrition

Thyroid disorders

The most common autoimmune disease causes thyroid hormone deficiency.

Lack of thyroid hormone can cause hair loss, weight gain, intellectual slowing and depression.

More common in women than men and frequently runs in families.

Thyroid hormone pathway

Why does Testosterone matter?

More than 14 million men in the US over 45 have low testosterone

Low testosterone is associated with a higher risk of diabetes, cardiovascular disease and bone mineral loss (osteoporosis).

A 2006 Study showed a higher mortality rate in veterans with low testosterone (35%) than those with normal levels (20%)

Andropause (testosterone deficiency)

As men age testosterone levels decline 1-2% yearly from the late 20’s on average.

Testosterone maintains muscle mass, bone density and sexual health.

Unlike menopause in women, loss of testosterone is usually gradual so men may not realize it is happening.

Symptoms of Andropause

Depressed Fat  Sleepless Tired/

Anxious Disinterested

• Achy• Fatigued • Memory loss or

brain fog • Loss of sexual

desire or function

How do I know if I need hormone replacement?

Documented deficiency on labs.

Symptoms of deficiency on surveys or questionnaires. Apathy, ED, low libido, fat gain, low energy, poor sleep, irritability, “half a man”

No contraindications to treatment

Testosterone and the Prostate

Testosterone does not cause prostate cancer

Low testosterone levels may be a risk for prostate cancer

A testosterone metabolite can cause BPH symptoms in some men

Testosterone optimization

• Non Bio-identical • Anabolics

Injectables• Winstrol• Dyanabol

• Bio-identical• Gels• Solutions• Implants• hCG

Bio-identical Hormones

Really “Human identical”What does it mean?

The exact same chemical structure that your body would produce.

Why is that important?Allows the body to

Recognize Utilize Metabolize

What Labs do I need?

TSH- Free T3-Free T4-Testosterone-Estradiol-LH*-PSACBC- to monitor blood cell production after

starting therapy

hCG

Used to stimulate the production of testosterone by the body.

A favored plan for young men who desire continued fertility.

Must be injected 1-3 times weekly.May not work in all cases.

Testosterone gels

Androgel/Fortesta/ Testim/compoundedApplied to skin daily at specific sites.Not everyone absorbs gels well.Available commercially (insurance

might pay)Must be careful about transference to

loved ones and friends.Odor may be objectionable (testim).

Testosterone solution

AxironApplied to the underarm/side area dailyUsually better absorbed than gelsMay be messyInsurance may payRisk of transference or product wasting due

to difficulty with usage.

Testosterone Implants

Proven technology for over 60 yearsSteady state of hormone release

closely mimics the body’s Easier to obtain optimal levelsLess roller coaster effectEasy dosing, most people receive

them 2 times yearly

Testosterone Implants

Convenient for those who travel

Minimally invasive procedure

Must decrease exercise for 1-2 weeks while incision heals.

Hormone Optimization

• Not all hormone therapies are created equal

• Hormone replacement therapy is not a “one-size-fits-all” approach

• You need a program based on your personal/family history and your lifestyle.

After hormone optimization

The age optimized person is hormonally, nutritionally, cardiovascularly, metabolically, aesthetically and neurologically balanced.

Expected benefits

Increased energy levelsRestored interest in lifeIncreased sexual driveConsistency in moodsRelief from anxiety and depressionIncreased mental clarityDecreased body fat and better exercise

toleranceBetter sleep

Patient Testimonial

“I go my life back! I feel like I am 25, not 54. I am able to work out and be active again. This is a miracle that continues to amaze me and everyday I am thankful for it.”

Kristie B.

“After two appointments of hormone replacement implant therapy, my life has really changed. People at work have commented on how sharp my memory is. My energy level is higher than most of the younger people I work with. And since my wife is also receiving implant therapy, we are both thrilled at the change in our libido. We are back to the way we were when we first met; our marriage really couldn’t be better!”

William H.

Patient Testimonial